|
Purchase by Fax
Please make PO out to
EZ Systems. Note: Pinnaclemicro's billing/invoices come from EZ
Systems*
TO: EZ Systems*
3400 W MacArthur Blvd., #E
Santa Ana, CA 92704
Tel:714-662-4959
Fax:714-662-6859
http://www.ezsystems.com |
My Email Address ?_______________________________ How did you find us ?__________________________
|
DATE:_______________________ Purchase Order
Number:__________________
BILL TO:Company:_____________________________________CONTACT:__________________________________
Street Address:
____________________________________________________________________________________
City, State, Zip:_____________________________________________________________________________________
SHIP TO:Company:_________________________________CONTACT:_________________________________
Street address:_________________________________________________________________________________
City, State, Zip:
________________________________________________________________________________
Buyer Contact:_____________________Phone#:________________ext.________Fax#:____________________
Technical Contact:________________Phone#:__________________ext._______Fax#:_____________________
| MFG PN# / Model |
Quantity |
Description |
Unit
Price |
Total |
Warranty / Condition |
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
Terms:_______ Credit Card#:___________________________Exp:_____Holder
Name:_________________________
Shipping UPS or Fedx: _________________ Overnight:________ 2 Day:________ 3
Day:_______ Ground:________
My UPS / Fedx Account #:__________________Bill me Yes or No:______
COMMENTS:__________________________________________________________
____________________________________________________________________
| 
